Evaluation of teamwork assessment tools for interprofessional simulation: a systematic literature review.

There is growing evidence supporting the use of simulation-based education to improve teamwork in the clinical environment, which results in improved patient outcomes. Interprofessional simulation improves awareness of professional roles and responsibilities, promotes teamwork and provides training in non-technical skills. Tools have been developed to assess the quality of teamwork during simulation, but the use of these tools should be supported by validity evidence in appropriate contexts. This study aims to assess the validity of teamwork tools used in simulation-based interprofessional training for healthcare workers and students, and to compare the design and reporting of these studies. Medline, EMBASE, ERIC, and CINAHL were searched using terms synonymous with simulation, crew resource management, training, assessment, interprofessional, and teamwork, from 2007-2017. Interprofessional healthcare simulation studies involving objectively rated teamwork training were included. The initial search provided 356 records for review, of which 24 were ultimately included. Three tools demonstrated good validity evidence underpinning their use. However, three studies did not explore tool psychometrics at all, and the quality of reporting amongst these studies on design and participant demographics was variable. Further research to generate reporting guidelines and validate existing tools for new populations would be beneficial.

Subgroup effects in a randomised trial of different types and doses of exercise during breast cancer chemotherapy.

BACKGROUND: The Combined Aerobic and Resistance Exercise Trial tested different types and doses of exercise in breast cancer patients receiving chemotherapy. Here, we explore potential moderators of the exercise training responses. METHODS: Breast cancer patients initiating chemotherapy (N=301) were randomly assigned to three times a week, supervised exercise of a standard dose of 25-30 min of aerobic exercise, a higher dose of 50-60 min of aerobic exercise, or a higher dose of 50-60 min of combined aerobic and resistance exercise. Outcomes were patient-reported symptoms and health-related fitness. Moderators were baseline demographic, exercise/fitness, and cancer variables. RESULTS: Body mass index moderated the effects of the exercise interventions on bodily pain (P for interaction=0.038), endocrine symptoms (P for interaction=0.029), taxane/neuropathy symptoms (P for interaction=0.013), aerobic fitness (P for interaction=0.041), muscular strength (P for interaction=0.007), and fat mass (P for interaction=0.005). In general, healthy weight patients responded better to the higher-dose exercise interventions than overweight/obese patients. Menopausal status, age, and baseline fitness moderated the effects on patient-reported symptoms. Premenopausal, younger, and fitter patients achieved greater benefits from the higher-dose exercise interventions. CONCLUSIONS: Healthy weight, fitter, and premenopausal/younger breast cancer patients receiving chemotherapy are more likely to benefit from higher-dose exercise interventions.

Duration and intensity of the radiation pulse from a flash tube.

The peak current, power, and half-peak duration of the current through a flash tube are determined. The flash tube may be considered as an element in an R-L-C circuit whose electrical behavior is dependent on a single parameter. The variation of tube current with voltage is examined and the plasma impedance determined. The intensity, rise time, decay time, and half-peak duration of the radiation pulse are determined for a range of tube geometries and gas pressures. The duration of the radiation pulse depends on that of the current, but the intensity is dependent on both gas pressure and power density.